3,727 research outputs found
An empirical investigation of the relationship between integration, dynamic capabilities and performance in supply chains
This research aimed to develop an empirical understanding of the relationships between integration,
dynamic capabilities and performance in the supply chain domain, based on which, two conceptual
frameworks were constructed to advance the field. The core motivation for the research was that, at
the stage of writing the thesis, the combined relationship between the three concepts had not yet
been examined, although their interrelationships have been studied individually.
To achieve this aim, deductive and inductive reasoning logics were utilised to guide the qualitative
study, which was undertaken via multiple case studies to investigate lines of enquiry that would
address the research questions formulated. This is consistent with the author’s philosophical
adoption of the ontology of relativism and the epistemology of constructionism, which was considered
appropriate to address the research questions. Empirical data and evidence were collected, and
various triangulation techniques were employed to ensure their credibility. Some key features of
grounded theory coding techniques were drawn upon for data coding and analysis, generating two
levels of findings. These revealed that whilst integration and dynamic capabilities were crucial in
improving performance, the performance also informed the former. This reflects a cyclical and
iterative approach rather than one purely based on linearity. Adopting a holistic approach towards
the relationship was key in producing complementary strategies that can deliver sustainable supply
chain performance.
The research makes theoretical, methodological and practical contributions to the field of supply
chain management. The theoretical contribution includes the development of two emerging
conceptual frameworks at the micro and macro levels. The former provides greater specificity, as it
allows meta-analytic evaluation of the three concepts and their dimensions, providing a detailed
insight into their correlations. The latter gives a holistic view of their relationships and how they are
connected, reflecting a middle-range theory that bridges theory and practice. The methodological
contribution lies in presenting models that address gaps associated with the inconsistent use of
terminologies in philosophical assumptions, and lack of rigor in deploying case study research
methods. In terms of its practical contribution, this research offers insights that practitioners could
adopt to enhance their performance. They can do so without necessarily having to forgo certain
desired outcomes using targeted integrative strategies and drawing on their dynamic capabilities
WHY DO REGIONAL SOCIAL POLICIES FAIL? Gendered Institutions and the Maputo Plan of Action
In 2005, the African Union (AU) developed a regional policy on sexual reproductive health (SRH) and rights aimed at improving member states’ SRH delivery, the Maputo Plan of Action (MPoA). It initially ran from 2006 to 2015 and was then extended to 2016 to 2030. However, the MPoA’s implementation has been slow and largely ineffective. This thesis explores the factors behind this ineffectiveness despite the apparent commitment to improving SRH delivery on the part of the AU member states as demonstrated by their collective development and adoption of the policy.
The thesis addresses reproductive health policy from a social policy perspective and begins its investigation by exploring existing regionalism literature that provides insights into why regionally integrated social policies oftentimes fail. The thesis finds that existing literature highlights specific institutional structures and path dependencies as factors that undermine regionalism’s efforts in social policy. In this thesis, I argue that these explanations, while relevant, offer only part of the story, because they do not consider the gendered character of regional organisations and the impact of this on policy formulation and implementation processes. I address this gap by exploring the role of gendered institutions in the design and delivery of regional social policies using the MPoA as a case study.
To develop this analysis, I use Feminist Institutionalism (FI) to study the gendered factors behind the ineffectiveness of the MPoA. Overall, I argue that the design, development and implementation processes of the MPoA are shaped by the gendered institutions of its host organisation, the AU, which undermine its priority setting, strategy development and resource allocation processes by undervaluing and trivialising the needs of women and girls, contributing to weak delivery. These gendered institutions are indicated by the exclusion of women in the AU structure, gendered sharing of roles and responsibilities and unequal opportunities to participate and influence AU processes. The thesis therefore concludes that the MPoA fails to deliver on SRH for women and girls due to the underlying gendered institutions of the AU that shaped the policy and drives in implementation in gendered ways. More broadly, the thesis concludes that regionally integrated social policies oftentimes fail because of the gendered character of regional organisations, which undermines policy formulation and implementation processes
Nutrient Intake and Physical Exercise as Modulators of Healthy Women
Cumulative evidence demonstrates that healthy nutrient intake and regular physical exercise are both powerful lifestyle strategies that modulate lifelong health through their ability to improve body composition, musculoskeletal health, sex steroid hormones, sleep quality, and physical and cognitive performance, as well as to prevent chronic diseases across the lifespan, especially in women. While the benefits of nutrition and physical exercise are commonly studied separately, the integration of nutrition and physical exercise has the potential to produce greater benefits in women than strategies focusing only on one or the other. Studying the specificities of women in response to interventions is of the utmost importance for providing optimal healthcare and aids the design of guidelines that are better suited for women. A better knowledge regarding nutrient intake and physical exercise and their interaction in women is therefore needed. This Special Issue entitled “nutrient intake and physical exercise as modulators of healthy women” will comprise manuscripts that highlight this integrational approach as a potential modulator of lifelong outcomes in women
Small newborns in post-conflict Northern Uganda: Burden and interventions for improved outcomes
Introduction: A small newborn can be the result of either a low birthweight (LBW), or a preterm birth (PB), or both. LBW can be due to either a preterm appropriate-for gestational-age (preterm-AGA), or a term small-for-gestational age (term-SGA) or intrauterine growth restriction (IUGR). An IUGR is a limited in-utero foetal growth rates or foetal weight < 10th percentile. Small newborns have an increased risk of dying, particularly in low-resource settings. We set out to assess the burden, the modifiable risk factors and health outcomes of small newborns in the post-conflict Northern Ugandan district of Lira. In addition, we studied the use of video-debriefing when training health staff in Helping Babies Breathe.
Subjects and methods: In 2018-19, we conducted a community-based cohort study on 1556 mother-infant dyads, nested within a cluster randomized trial. In our cohort study, we estimated the incidence and risk factors for LBW and PB and the association of LBW with severe outcomes. We explored the prevalence of and factors associated with neonatal hypoglycaemia, as well as any association between neonatal death and hypoglycaemia. In addition, we conducted a cluster randomized trial to compare Helping Babies Breathe (HBB) training in combination with video debriefing to the traditional HBB training alone on the attainment and retention of health worker neonatal resuscitation competency.
Results: The incidence of LBW and PB in our cohort was lower than the global estimates, 7.3% and 5.0%, respectively. Intermittent preventive treatment for malaria was associated with a reduced risk of LBW. HIV infection was associated with an increased risk of both LBW and PB, while maternal formal education (schooling) of ≥7 years was associated with a reduced risk of LBW and PB.
The proportions of neonatal deaths were many-folds higher among LBW infants compared to their non-LBW counterparts. The proportion of neonatal deaths among LBW was 103/1000 live births compared to 5/1000 among the non-LBW.
The prevalence of neonatal hypoglycaemia in our cohort was 2.5%. LBW and PB each independently were associated with an increased risk of neonatal hypoglycaemia. Neonatal hypoglycaemia was associated with an increased risk of hospitalisation and severe outcomes.
We demonstrated that neonatal resuscitation training with video debriefing, improved competence attainment and retention among health workers, compared to traditional HBB training alone.
Conclusion: In northern Uganda, small infants still have a many-fold higher risk of dying compared to normal infants. In addition, small infants are also at more risk of neonatal hypoglycaemia compared to normal infants. Efforts are needed to secure essential newborn care, should we reach the target of Sustainable Development Goal number 3.2 of reducing infant mortality to less than 12/1000 live births by 2030
Exploring the Training Factors that Influence the Role of Teaching Assistants to Teach to Students With SEND in a Mainstream Classroom in England
With the implementation of inclusive education having become increasingly valued over the years, the training of Teaching Assistants (TAs) is now more important than ever, given that they work alongside pupils with special educational needs and disabilities (hereinafter SEND) in mainstream education classrooms. The current study explored the training factors that influence the role of TAs when it comes to teaching SEND students in mainstream classrooms in England during their one-year training period. This work aimed to increase understanding of how the training of TAs is seen to influence the development of their personal knowledge and professional skills. The study has significance for our comprehension of the connection between the TAs’ training and the quality of education in the classroom. In addition, this work investigated whether there existed a correlation between the teaching experience of TAs and their background information, such as their gender, age, grade level taught, years of teaching experience, and qualification level.
A critical realist theoretical approach was adopted for this two-phased study, which involved the mixing of adaptive and grounded theories respectively. The multi-method project featured 13 case studies, each of which involved a trainee TA, his/her college tutor, and the classroom teacher who was supervising the trainee TA. The analysis was based on using semi-structured interviews, various questionnaires, and non-participant observation methods for each of these case studies during the TA’s one-year training period. The primary analysis of the research was completed by comparing the various kinds of data collected from the participants in the first and second data collection stages of each case. Further analysis involved cross-case analysis using a grounded theory approach, which made it possible to draw conclusions and put forth several core propositions. Compared with previous research, the findings of the current study reveal many implications for the training and deployment conditions of TAs, while they also challenge the prevailing approaches in many aspects, in addition to offering more diversified, enriched, and comprehensive explanations of the critical pedagogical issues
Annual SHOT Report 2018
SHOT is affiliated to the Royal College of PathologistsAll NHS organisations must move away from a blame culture towards a just and learning culture. All clinical and laboratory staff should be encouraged to become familiar with human factors and ergonomics concepts. All transfusion decisions must be made after carefully assessing the risks and benefits of transfusion therapy. Collaboration and co-ordination among staff is vital
Anuário científico da Escola Superior de Tecnologia da Saúde de Lisboa - 2021
É com grande prazer que apresentamos a mais recente edição (a 11.ª) do Anuário Científico da Escola Superior de Tecnologia da Saúde de Lisboa. Como instituição de ensino superior, temos o compromisso de promover e incentivar a pesquisa científica em todas as áreas do conhecimento que contemplam a nossa missão. Esta publicação tem como objetivo divulgar toda a produção científica desenvolvida pelos Professores, Investigadores, Estudantes e Pessoal não Docente da ESTeSL durante 2021. Este Anuário é, assim, o reflexo do trabalho árduo e dedicado da nossa comunidade, que se empenhou na produção de conteúdo científico de elevada qualidade e partilhada com a Sociedade na forma de livros, capítulos de livros, artigos publicados em revistas nacionais e internacionais, resumos de comunicações orais e pósteres, bem como resultado dos trabalhos de 1º e 2º ciclo. Com isto, o conteúdo desta publicação abrange uma ampla variedade de tópicos, desde temas mais fundamentais até estudos de aplicação prática em contextos específicos de Saúde, refletindo desta forma a pluralidade e diversidade de áreas que definem, e tornam única, a ESTeSL. Acreditamos que a investigação e pesquisa científica é um eixo fundamental para o desenvolvimento da sociedade e é por isso que incentivamos os nossos estudantes a envolverem-se em atividades de pesquisa e prática baseada na evidência desde o início dos seus estudos na ESTeSL. Esta publicação é um exemplo do sucesso desses esforços, sendo a maior de sempre, o que faz com que estejamos muito orgulhosos em partilhar os resultados e descobertas dos nossos investigadores com a comunidade científica e o público em geral. Esperamos que este Anuário inspire e motive outros estudantes, profissionais de saúde, professores e outros colaboradores a continuarem a explorar novas ideias e contribuir para o avanço da ciência e da tecnologia no corpo de conhecimento próprio das áreas que compõe a ESTeSL. Agradecemos a todos os envolvidos na produção deste anuário e desejamos uma leitura inspiradora e agradável.info:eu-repo/semantics/publishedVersio
Simulation in neonatal resuscitation
Approximately 1 in 10 newborns will require basic resuscitation interventions at birth. Some infants progress to require more advanced measures including the provision of positive pressure ventilation, chest compressions, intubation and administration of volume/cardiac medications. Although advanced resuscitation is infrequent, it is crucial that personnel adequately trained in these techniques are available to provide such resuscitative measures. In 2000, Louis Halmalek et al. called for a "New Paradigm in Pediatric Medical Education: Teaching Neonatal Resuscitation in a Simulated Delivery Room Environment." This was one of the first articles to highlight simulation as a method of teaching newborn resuscitation. The last decades have seen an exponential growth in the area of simulation in newborn care, in particular in newborn resuscitation and stabilization. Simulation is best defined as an instructional strategy "used to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner." Simulation training has now become an important point of how we structure training and deliver improved healthcare to patients. Some of the key aspects of simulation training include feedback, deliberate practice, outcome measurement, retention of skills and curriculum integration. The term "Train to win" is often used in sporting parlance to define how great teams succeed. The major difference between sports teams is that generally their game day comes once a week, whereas in newborn resuscitation every day is potentially "game day." In this review we aim to summarize the current evidence on the use of simulation based education and training in neonatal resuscitation, with particular emphasis on the evidence supporting its effectiveness. We will also highlight recent advances in the development of simulation based medical education in the context of newborn resuscitation to ensure we "train to win.
Instrumentation and validation of a robotic cane for transportation and fall prevention in patients with affected mobility
Dissertação de mestrado integrado em Engenharia Física, (especialização em Dispositivos, Microssistemas e Nanotecnologias)O ato de andar é conhecido por ser a forma primitiva de locomoção do ser humano, sendo que este
traz muitos benefícios que motivam um estilo de vida saudável e ativo. No entanto, há condições de saúde
que dificultam a realização da marcha, o que por consequência pode resultar num agravamento da saúde,
e adicionalmente, levar a um maior risco de quedas. Nesse sentido, o desenvolvimento de um sistema de
deteção e prevenção de quedas, integrado num dispositivo auxiliar de marcha, seria essencial para reduzir
estes eventos de quedas e melhorar a qualidade de vida das pessoas. Para ultrapassar estas necessidades
e limitações, esta dissertação tem como objetivo validar e instrumentar uma bengala robótica, denominada
Anti-fall Robotic Cane (ARCane), concebida para incorporar um sistema de deteção de quedas e um
mecanismo de atuação que possibilite a prevenção de quedas, ao mesmo tempo que assiste a marcha.
Para esse fim, foi realizada uma revisão do estado da arte em bengalas robóticas para adquirir um
conhecimento amplo e aprofundado dos componentes, mecanismos e estratégias utilizadas, bem como os
protocolos experimentais, principais resultados, limitações e desafios em dispositivos existentes.
Numa primeira fase, foi estipulado o objetivo de: (i) adaptar a missão do produto; (ii) estudar as
necessidades do consumidor; e (iii) atualizar as especificações alvo da ARCane, continuação do trabalho de
equipa, para obter um produto com design e engenharia compatível com o mercado. Foi depois estabelecida
a arquitetura de hardware e discutidos os componentes a ser instrumentados na ARCane. Em seguida foram
realizados testes de interoperabilidade a fim de validar o funcionamento singular e coletivo dos componentes.
Relativamente ao controlo de movimento, foi desenvolvido um sistema inovador, de baixo custo e
intuitivo, capaz de detetar a intenção do movimento e de reconhecer as fases da marcha do utilizador. Esta
implementação foi validada com seis voluntários saudáveis que realizaram testes de marcha com a ARCane
para testar sua operabilidade num ambiente de contexto real. Obteve-se uma precisão de 97% e de 90% em
relação à deteção da intenção de movimento e ao reconhecimento da fase da marcha do utilizador.
Por fim, foi projetado um método de deteção de quedas e mecanismo de prevenção de quedas para
futura implementação na ARCane. Foi ainda proposta uma melhoria do método de deteção de quedas, de
modo a superar as limitações associadas, bem como a proposta de dispositivos de deteção a serem
implementados na ARCane para obter um sistema completo de deteção de quedas.The act of walking is known to be the primitive form of the human being, and it brings many benefits
that motivate a healthy and active lifestyle. However, there are health conditions that make walking difficult,
which, consequently, can result in worse health and, in addition, lead to a greater risk of falls. Thus, the
development of a fall detection and prevention system integrated with a walking aid would be essential to
reduce these fall events and improve people quality of life. To overcome these needs and limitations, this
dissertation aims to validate and instrument a cane-type robot, called Anti-fall Robotic Cane (ARCane),
designed to incorporate a fall detection system and an actuation mechanism that allow the prevention of
falls, while assisting the gait. Therefore, a State-of-the-Art review concerning robotic canes was carried out to
acquire a broad and in-depth knowledge of the used components, mechanisms and strategies, as well as
the experimental protocols, main results, limitations and challenges on existing devices.
On a first stage, it was set an objective to (i) enhance the product's mission statement; (ii) study the
consumer needs; and (iii) update the target specifications of the ARCane, extending teamwork, to obtain a
product with a market-compatible design and engineering that meets the needs and desires of the ARCane
users. It was then established the hardware architecture of the ARCane and discussed the electronic
components that will instrument the control, sensory, actuator and power units, being afterwards subjected
to interoperability tests to validate the singular and collective functioning of cane components altogether.
Regarding the motion control of robotic canes, an innovative, cost-effective and intuitive motion
control system was developed, providing user movement intention recognition, and identification of the user's
gait phases. This implementation was validated with six healthy volunteers who carried out gait trials with
the ARCane, in order to test its operability in a real context environment. An accuracy of 97% was achieved
for user motion intention recognition and 90% for user gait phase recognition, using the proposed motion
control system.
Finally, it was idealized a fall detection method and fall prevention mechanism for a future
implementation in the ARCane, based on methods applied to robotic canes in the literature. It was also
proposed an improvement of the fall detection method in order to overcome its associated limitations, as
well as detection devices to be implemented into the ARCane to achieve a complete fall detection system
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